What is Preterm delivery?
The average normal length of a pregnancy is 40 weeks. Preterm delivery is one that takes place about three or more weeks prior to the expected due date. This is at a gestational age of 37 weeks or earlier.
A high percentage of babies born as early as 26 weeks usually make it to their first birthday. There is an increase in survival rate as the gestational age progresses. Babies that are born prematurely will require several weeks of intensive care.
What are the risk factors that contribute to Preterm delivery?
There is no definitive way of knowing that a certain delivery will be preterm. Not all preterm deliveries have underlying causes. A few of the contributory factors for preterm delivery include:
- Previous preterm deliveries
- Multiple pregnancies (twins, triplets, etc)
- Structural anomalies with the uterus, cervix, etc
- Being underweight or overweight during and before pregnancy
- Smoking and use of illicit drugs
- Alcohol consumption
- Infections, particularly those affecting the reproductive tract
- History of chronic conditions like diabetes
- History of abortions or miscarriages
While these are risk factors, it doesn’t indicate a definitive guideline for preterm deliveries. Many women might have one or more of these risk factors and carry their pregnancy to full term.
What are the signs and symptoms a woman experiences while she goes into preterm delivery?
Most preterm deliveries occur spontaneously without a preceding event. Women undergo regular and frequent contractions. This can start out as low back pain, mild cramping with or without vaginal spotting or bleeding. Some cases can progress like normal labour with the “water-breaking” followed by regular contractions.
What are the risks an infant encounters by being born Prematurely?
All babies that are born prematurely have to placed under intensive care and require close monitoring.
Premature babies are underweight and appear small in size. Due to minimal fat stores, they can appear to be lean with more prominent features. Due to the thin skin, premature babies have a purplish-red hue due to the presence of superficial blood vessels.
The younger, the infants are, they are less likely to swallow, suck or feed on their own. They receive most of their nutrition intravenously. As they grow older, tube feeding and suckling can be attempted.
Premature babies will have diminished muscle tone and will attempt to move very little. They will not have similar reflexes to that of a full-term baby. However, they can grasp a finger and cry intermittently. They may stay awake for a few hours a day but will be observed to be sleeping for most of the day.
The main concern for babies that are born prematurely is their capacity to breathe. Complete lung function is one of the last to develop. A product called surfactant which keeps air sacs patent is produced at about 24 weeks of gestation. The complete function of the lungs is attained by 35 weeks of gestation. Babies born before this time will require support to breathe efficiently.
Other complications premature babies might encounter includes:
- Inadequate body temperature control
- Structural heart defects
- Bleeding in the brain
- Immature gastrointestinal system
- Immature immune system
All premature babies do not encounter complications. Just the risk of complications increases if a baby is born prematurely. With proper care, babies thrive well following delivery.
When can parents take their Premature baby home?
A few parameters are observed before a premature baby can be taken home. Ideally, premature babies will be kept in the neonatal intensive care unit until they can:
- Moderate their own body temperature
- Gain weight steadily
- Breastfeed or bottle feed
- Independently maintain heart rate and breathing rate
- Have most diagnostic tests are within a normal range
How do parents take care of their premature babies at home?
Before parents can take their babies home, hospital staff will educate caregivers about the requirements for taking care of a premature infant. Specific care pertaining to any possible medical conditions will be highlighted before going home.
Taking care of a premature infant is no different from taking care of an infant born at term. Here are a few tips for taking care of your premature baby:
- Since your baby’s immune system is still developing, your child will be indoors most of the time.
- Increase skin-to-skin contact. This is when you place your baby, who is only dressed in a nappy, on your bare chest. Parents can take turns doing this. This helps to provide warmth as well as increase bonding between babies and primary caregivers. This technique is referred to as “Kangaroo Mother Care.”
- Maintaining optimal hygiene practises at home is a must. This means washing hands regularly as well as keeping the house clean and dust-free.
- Dress your baby in layers as this will help with moderating your baby’s body temperature. Asking a healthcare professional about swaddling your baby would be ideal. Swaddling enhances body temperature, provides security and limits your baby’s startle reflex.
- Your baby should sleep on his/her back in a cot that has minimal mattresses, pillows and blankets. This is to prevent sudden infant death syndrome.
- Due to your baby’s fragile skin, it is best to avoid frequent bathing. Babies can have a bath once or twice a week. Bathing involves light sponging, especially until the umbilical cord falls off.
- In the first six months of your babies life, they will be exclusively breastfed. Breast milk is the primary source of nutrition. Formula milk can be considered as a substitute.
- Babies will not sleep throughout the night. Your baby will wake up several times during the day to feed. Every time your baby wakes up attempt feeding. Premature babies will feed more often.
The arrival of a newborn is a great moment in a parent’s life. Parents anticipate the best for their newborn.
Premature delivery is never anticipated. However, today with the advances in medical science and well trained medical professionals, taking care of your preemie shouldn’t be a cause for concern. Your health care professional will teach you the basics of taking care of your child at home.
Ask as many questions as you might have before discharge and during doctor visits. When in doubt, do not hesitate to consult with your paediatrician.
It is also essential that parents of newborns work out ways to take care of their own general health and well being. Taking out specific time in the day for self-care is vital. Couples need to help each other out, and also ask for assistance within their close circles.
Premature babies might have to be in the hospital for a few days, weeks or months, depending on how premature the child is and also the care the baby will require. This can be emotionally taxing for parents.
Support groups, counsellors, as well as forming a safe space within your home to discuss your feelings is essential.